SCS for Patient With Painful Diabetic Neuropathy and Peripheral Arterial Disease

Description

The study involves permanent spinal cord stimulator (SCS) placement in participants with peripheral arterial disease (PAD) and painful diabetic neuropathy (PDN). Participants will be between 19 and 89 years old, have diabetes with symptoms of neuropathy, and have a starting pain level of at least 5 cm on a visual pain scale. They must also have PAD, confirmed by an ankle-brachial index under 0.90 or vascular imaging, and experience pain from walking with a pain level of at least 6 cm for at least 3 months. Their Vascular Quality of Life Questionnaire score should be 5.5 or less, and they must be good candidates for SCS. The study includes initial evaluation visits, follow up after their permanent SCS is placed and optimized 12 weeks in the clinic at this time the study interventions begin and the patient is followed for four weeks; two weeks of stimulation and two weeks of sham intervention in random order, and intervention evaluations. At each follow up visit pain, sensory, functional, vascular, and autonomic outcomes will be assessed, after which patients will return to standard SCS care. The total time for the study intervention is 4 weeks.

Conditions

Peripheral Arterial Disease, Painful Diabetic Neuropathy, Diabetes Mellitus, Type 2, Chronic Pain, Spinal Cord Stimulation, Chronic Pain Syndrome, Limb Pain

Study Overview

Study Details

Study overview

The study involves permanent spinal cord stimulator (SCS) placement in participants with peripheral arterial disease (PAD) and painful diabetic neuropathy (PDN). Participants will be between 19 and 89 years old, have diabetes with symptoms of neuropathy, and have a starting pain level of at least 5 cm on a visual pain scale. They must also have PAD, confirmed by an ankle-brachial index under 0.90 or vascular imaging, and experience pain from walking with a pain level of at least 6 cm for at least 3 months. Their Vascular Quality of Life Questionnaire score should be 5.5 or less, and they must be good candidates for SCS. The study includes initial evaluation visits, follow up after their permanent SCS is placed and optimized 12 weeks in the clinic at this time the study interventions begin and the patient is followed for four weeks; two weeks of stimulation and two weeks of sham intervention in random order, and intervention evaluations. At each follow up visit pain, sensory, functional, vascular, and autonomic outcomes will be assessed, after which patients will return to standard SCS care. The total time for the study intervention is 4 weeks.

Spinal Cord Stimulation for Patients With Painful Diabetic Neuropathy and Peripheral Arterial Disease: Mechanistic Insights From a Single-center, Randomized, Blinded, Sham-controlled Cross-over Proof-of-concept Trial

SCS for Patient With Painful Diabetic Neuropathy and Peripheral Arterial Disease

Condition
Peripheral Arterial Disease
Intervention / Treatment

-

Contacts and Locations

Omaha

University of Nebraska Medical Center, Omaha, Nebraska, United States, 68198

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Patients aged 19 years to 89 years with diabetes mellitus
  • * Signs or symptoms of neuropathy and maximum baseline visual-analog pain scale ≥ 5 cm and peripheral arterial disease (diagnosed by ankle-brachial index \< 0.90 or vascular imaging studies) with claudication and exertion-induced visual-analog pain scale ≥ 6 cm for a minimum of 3 months.
  • * Patients who have undergone a successful (\>50% relief of chronic lower extremity pain) SCS trial, are appropriate candidates for permanent SCS and will have had new permanent SCS placed prior to study intervention.
  • * uncontrolled psychological or psychiatric disorder
  • * inability to hold antithrombotic therapy per the American Society of Regional Anesthesia guidelines
  • * non-healing wounds
  • * gangrene
  • * critical limb ischemia
  • * prior lower extremity amputation
  • * inability to adhere to study follow-up
  • * mechanical spine instability based on flexion/extension radiographs of the lumbar spine
  • * prior or current spinal cord stimulator implant

Ages Eligible for Study

19 Years to 89 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

University of Nebraska,

Peter Pellegrino, MD, PRINCIPAL_INVESTIGATOR, University of Nebraska

Study Record Dates

2026-12